{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:05:43Z","timestamp":1789725943791,"version":"4.0.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca plc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Human metapneumovirus (hMPV) is commonly associated with respiratory tract infections (RTIs) in young children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We estimated the annual hospital incidence of hMPV RTIs in children under 5 years in Scotland from 2017 to 2023 using national hospital and laboratory data. Incidence outside Lothian, where testing practices were uncertain, was extrapolated from Lothian laboratory data, where hMPV testing was advised for all RTI admissions. We also examined the severity and mortality of laboratory-confirmed hMPV cases. We developed similar estimates for respiratory syncytial virus (RSV) and influenza A for comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This analysis included 1462 laboratory-confirmed hMPV hospitalizations in children aged under 5 years. The extrapolated hMPV hospital incidence ranged from 19 per 100 000 to 537 per 100 000 in children aged under 5 years. The extrapolated incidence was 2 to 3 times higher than that based on laboratory-confirmed data. Hospital incidence was higher in infants than in toddlers. hMPV incidence dropped substantially during the 2020\/21 season, followed by a rebound during the 2021\/22 season. About 10% of hMPV RTI hospital admissions required hospital stay \u22655 days, but &amp;lt;1% required intensive care unit admissions or resulted in in-hospital death. RSV hospital incidence appeared substantially higher than the hMPV hospital incidence in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>hMPV RTIs contribute to a substantial hospital burden in young children in Scotland. However, the RSV RTI burden is likely to be higher in the population unvaccinated against both viruses. Improved surveillance and diagnosis strategies are required to develop robust hospital burden estimates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag532","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:24:16Z","timestamp":1787570656000},"source":"Crossref","is-referenced-by-count":0,"title":["Human Metapneumovirus-Associated Hospitalization Burden in Children Aged Under 5 Years in Scotland Between 2017 and 2023: a Retrospective Analysis"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7680-1168","authenticated-orcid":false,"given":"Durga","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Centre for Global Health, Usher Institute, University of Edinburgh , Edinburgh ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-3691","authenticated-orcid":false,"given":"Richard","family":"Osei-Yeboah","sequence":"additional","affiliation":[{"name":"Centre for Global Health, Usher Institute, University of Edinburgh , Edinburgh ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Templeton","sequence":"additional","affiliation":[{"name":"Viral Genotyping Reference Laboratory Edinburgh, NHS Lothian, Royal Infirmary of Edinburgh , Edinburgh ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9432-9100","authenticated-orcid":false,"given":"Harish","family":"Nair","sequence":"additional","affiliation":[{"name":"Centre for Global Health, Usher Institute, University of Edinburgh , Edinburgh ,","place":["UK"]},{"name":"School of Public Health, Nanjing Medical University , Nanjing ,","place":["China"]},{"name":"MRC\/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"2026091805320271500_ofag532-B1","doi-asserted-by":"crossref","first-page":"2466","DOI":"10.3389\/fimmu.2018.02466","article-title":"Human metapneumovirus: mechanisms and molecular targets used by the virus to avoid the immune system","volume":"9","author":"Soto","year":"2018","journal-title":"Front Immunol"},{"key":"2026091805320271500_ofag532-B2","doi-asserted-by":"crossref","first-page":"e70043","DOI":"10.1002\/rmv.70043","article-title":"Human metapneumovirus: a review of its epidemiology, clinical features, public health implications and treatment options","volume":"35","author":"Twumasi","year":"2025","journal-title":"Rev Med Virol"},{"key":"2026091805320271500_ofag532-B3","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1016\/S2214-109X(20)30393-4","article-title":"Global burden of acute lower respiratory infection associated with human metapneumovirus in children under 5 years in 2018: a systematic review and modelling study","volume":"9","author":"Wang","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2026091805320271500_ofag532-B4","author":"U.S. Centers for Disease Control and Prevention"},{"key":"2026091805320271500_ofag532-B5","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.3390\/v17081140","article-title":"Human metapneumovirus: a narrative review on emerging strategies for prevention and treatment","volume":"17","author":"Principi","year":"2025","journal-title":"Viruses"},{"key":"2026091805320271500_ofag532-B6","doi-asserted-by":"crossref","first-page":"ofag057","DOI":"10.1093\/ofid\/ofag057","article-title":"Human metapneumovirus-associated hospital burden in older adults in Scotland: a retrospective analysis","volume":"13","author":"Kulkarni","year":"2026","journal-title":"Open Forum Infect Dis"},{"key":"2026091805320271500_ofag532-B7","author":"National Records of Scotland"},{"key":"2026091805320271500_ofag532-B8","author":"NHS Scotland"},{"key":"2026091805320271500_ofag532-B9","author":"National Records of Scotland"},{"key":"2026091805320271500_ofag532-B10","author":"Public Health Scotland"},{"key":"2026091805320271500_ofag532-B11","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1093\/infdis\/jiac150","article-title":"Age-specific estimates of respiratory syncytial virus-associated hospitalizations in 6 European countries: a time series analysis","volume":"226","author":"Johannesen","year":"2022","journal-title":"J Infect Dis"},{"key":"2026091805320271500_ofag532-B12","author":"Public Health Scotland"},{"key":"2026091805320271500_ofag532-B13","author":"Public Health Scotland"},{"key":"2026091805320271500_ofag532-B14","author":"Public Health Scotland"},{"key":"2026091805320271500_ofag532-B15","author":"Public Health Scotland"},{"key":"2026091805320271500_ofag532-B16","author":"National Records of Scotland"},{"key":"2026091805320271500_ofag532-B17","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1016\/S0140-6736(16)30388-9","article-title":"Guidelines for accurate and transparent health estimates reporting: the GATHER statement","volume":"388","author":"Stevens","year":"2016","journal-title":"The Lancet"},{"key":"2026091805320271500_ofag532-B18","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1128\/CMR.00014-06","article-title":"Epidemiology of human metapneumovirus","volume":"19","author":"Kahn","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"2026091805320271500_ofag532-B19","doi-asserted-by":"crossref","first-page":"e2024070218","DOI":"10.1542\/peds.2024-070218","article-title":"Human metapneumovirus and respiratory syncytial virus in children: a comparative analysis","volume":"156","author":"Goldstein","year":"2025","journal-title":"Pediatrics"},{"key":"2026091805320271500_ofag532-B20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12968\/hmed.2022.0349","article-title":"Immunity debt and unseasonal childhood respiratory viruses","volume":"89","author":"Munro","year":"2022","journal-title":"Br J Hosp Med (Lond)"},{"key":"2026091805320271500_ofag532-B21","author":"NHS 24"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag532\/70819342\/ofag532.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/9\/ofag532\/70819342\/ofag532.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/9\/ofag532\/70819342\/ofag532.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:32:55Z","timestamp":1789723975000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag532\/8771815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag532","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,27]]},"article-number":"ofag532"}}